Friday, July 29, 2016

Training on Empty: Chapter 30

Chapter 30 – Living to Die

“[W]e now know that the human animal is characterized by two great fears that other animals are protected from: the fear of life and the fear of death... Heidegger brought these fears to the center of his existential philosophy. He argued that the basic anxiety of [humanity] is anxiety about being-in-the-world, as well as anxiety of being-in-the-world. That is, both fear of death and fear of life, of experience and individuation.” – Ernest Becker

It seems a bizarre irony that someone so afraid of death would have taken her life right up to the edge for a possible glimpse of the other side. Perhaps I thought I was facing my fear. Regardless, confronting the reality that I might soon die – which I had to do more than once – never actually eased my intense phobia. If anything, it only made it worse. When I was in the throes of anorexia, I would often consider that any given moment could be my last. However, I was never able to let go of all the limitations and restrictions I had placed on myself. I had a bad case of the what-might-bes. I would think of all the foods I had missed tasting, all the life I had missed living, and all the people I had missed meeting. My life had become so narrow, uneventful and gloomy. I needed to know how the story would end, and I didn't want it to end like it was threatening to. It took years for me to reach any kind of balance and start sampling life again. Just as I was beginning to emerge from the ugly black pit of my past, I was struck with the intense feeling I was going to die.

There have been several times in my life when I have come face-to-face with death. The first incident was in grade school. I was at home playing with a friend and suddenly felt a terrible headache coming on. The headache was so bad that I had to ask my friend to leave so I could go lie down. The pain intensified quickly. Before I could even attempt to call out to my mom down the hallway in the other room, I became paralyzed from the severe throbbing pressure growing in my skull. It was as if my brain was going to explode. Any slight movement was far too painful to tolerate, so I stayed as still as possible for over an hour until my mom finally came looking for me. When she entered the room, I saw her panicked face as she leaned over me. My eyes had glazed over and we both thought I would be dead shortly. “My head,” I managed to whisper. She called the hospital, but the nurse told her there was an epidemic of viral meningitis going around. Chances were I was another case. The hospital was swamped. My mom was told to call back only if I didn’t improve over the next three hours and an ambulance would be sent. Viral meningitis is described as a swelling of the outer layer of the brain. It is extremely painful and can cause brain damage, deafness, blindness, and in some instances, death. Fortunately, the pain lessened over the course of the night, and it was indeed, as the ER operator had expected, viral meningitis and not a related – but often lethal – disease, bacterial meningitis. I recovered fully over the next few days and was back to my normal activity in less than a week. Many years later, when I was in my early forties, I would be struck down again with this illness in a much more severe case. Miraculously, in the latter case, after nine days in the hospital with my life hanging in the balance, I was released and started a slow recovery. As a friend of the family put it, "You have bad luck." However, I have to recognize that living in a state of malnutrition for so long probably didn't help me have good luck when it comes to health.

Another brush with death I experienced was in college, when I went river-rafting with a few friends. It was my first experience in a raft. I had grand images of sunning myself on a spacious raft on the calm waters. When the river guide started pumping up the tiny inflatable vessels by hand, my daydream came to a disappointing halt.

I should have figured out that the trip was cursed when, as we were waiting to shove off into the mild waters, a big spider crawled over my hand. We split up into two teams, and just as my team was beginning to get the hang of maneuvering the tiny little raft, the guide yelled out for us to paddle as hard as we could. I heard a loud roar of rushing water before us, and as I lifted my oar out of the water fully intending to plunge it back in as hard as I possibly could, the raft flipped and I was sucked under. My first instinct was to fight to reach the surface, but I was being pulled under with such force, I knew that any effort would be futile. A strange calm took over me as I looked up and saw the raft getting farther and farther away. I convinced myself that the force pulling me down had to stop at some point. I was right. The moment I felt the eddy release me, I swam for the surface with a fury that I had never known before. I could see the sun on the water above me. It seemed so incredibly far away though. I was completely out of breath with a good three feet left to swim. Time stood still and all was quiet just before I broke into the air and sputtered and coughed as the guide quickly maneuvered the raft to me and pulled me aboard.

As traumatic as this was, it was my most serene confrontation with death to date. Somehow the thought of nature being in control had, at that moment, eased my worries about death. The force of nature was something I realized then that I couldn’t fight. If the eddy had continued to pull me under, it was beyond my control to fight. This sense of serenity in the hands of some universal force did not, however, transfer to the relatively microscopic environment of my own body. Once I became anorexic, the seizures and near-death experiences were filled with terror and fear, and just when I thought it was all behind me, I once again came face-to-face with my own mortality.

After I ran my first marathon, I started to experience severe stiffness in my pelvis, hamstrings, lower back and hips. It was such an accomplishment to have finished the marathon, regardless of my time. Despite running much more slowly than I had in the past, I felt satisfied and even a little bit emotional crossing the finish line. Unfortunately, shortly after the race, everything started to hurt, and I could hardly step up a single stair riser normally, let alone jog. It didn’t make sense that I would be this sore when I hadn’t truly raced the marathon and even stopped twice. I saw over 11 practitioners, from chiropractors to medical doctors, none of whom could offer any help or provide a clue as to what was going on in my body. In addition to the chronic stiffness, I was beginning to experience panic attacks. I was worried the seizures were coming back, but I couldn’t figure out why they would occur since my weight and electrolytes were stable. The attacks started fairly mildly; I would get a funny sensation in my back and experience a sense of worry and fear. I tried in vain to reassure myself everything was okay, that I was going to be fine, but the attacks got progressively worse. Eventually I was getting full-blown fight-or-flight responses for no apparent reason.

At this time I was working as a nanny for two fun, outgoing kids in addition to working part-time at a local health-food store. I had to miss a few days of work when the panic became severe, and I noticed both chest pain and shortness of breath. Convinced I had wrecked my body and was paying for my anorexic past, I assumed I was about to have a heart attack. I went to the emergency room in tears with the distinct feeling I was going to die. I was very scared. The fear seemed beyond my control; no amount of positive self-talk could ease my worries and physical symptoms.

For so many years, I had been living in limbo. It seemed unfair that death would squeeze its icy fingers around my heart just at the time I was deciding I wanted to live and not merely exist. In the past, I had lived by default: too afraid to actually kill myself, but equally afraid to really be in the world. I had fallen to a certain level of mediocrity, no longer a heroic athlete or super student. I felt I had failed Life 101. I was thin though, and that meant something. It seemed it was the only thing over which I had any control. Here I was, finally stepping up to experience all I had been missing, and there was death staring at me once again. For the first time in over five years, I was starting to feel again. I even had a slight crush on one of the guys at the health-food store and had gone on my first date in what felt like an eternity. I remember our first kiss like it was my first ever. Suddenly a door that had been closed was thrown open, and I was aware of my own sexuality. The thought of a heart attack sickened me and made me realize my own fate was out of my hands. Eating more or eating less would not solve this problem. I realized how little control one actually does have in life.

The doctor who saw me that day reassured me that my heart was beating fine. She did detect a clicking sound and ordered an ultrasound, which revealed a heart-valve leak. She called it mitral valve prolapse and told me the condition itself actually causes panic attacks. What occurs is a physical response, not a mental or emotional episode. I was instructed to give up chocolate, caffeine, teas and any stimulants and watch my blood-sugar levels. Homeostasis was best for keeping the panic attacks and other symptoms at bay.

With the panic attacks resolved, I was left to once again deal with the pain and stiffness issue. I had started running again in order to train for another marathon or perhaps a half-marathon, but I suffered on my long runs. I shuffled and limped along with my running partners and had trouble keeping up. Running with my new circle of friends had previously allowed me to open up and feel more at ease with myself. However, the pain was forcing me to shut down a bit. Once the chatterbox of the group, I had become quiet and would often fall so far back that my training buddies had to circle around to pick me up again. After a failed attempt to run a half-marathon, I decided to get a coach and see another chiropractor. These would be two of the best moves I ever made in my life.

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Training on Empty: Chapter 29 (Possible TW)

Possible trigger warning with mention of behaviors and numbers.

Chapter 29 – Leap of Faith

“God comes to the hungry in the form of food.” – Mahatma Gandhi Quotes, Mahatma Gandhi  

As with any other addiction, anorexia is a means for someone whose life may feel out of control to establish a false sense of security. Unable to control events outside themselves, addicts control their immediate environment. There is considerable irony in that the addiction ultimately ends up controlling the individual, but there is comfort in knowing that the situation, as bad as it may become, won’t change. Sometimes pain when one expects it is easier to handle than when outcomes are left up to fate. An extreme example of this is when victims of physically or verbally abusive perpetrators start an argument. Knowing when the slap or verbal attack is coming allows them to prepare for the blow and move on more quickly after the fact. Most often, a sense of the world being unpredictable stems from continually being let down by the universe; a parent failing to show love, a relationship ending abruptly, a lost job, a friend’s death. Although addiction temporarily offers a sense of control, everyone knows life is something that can’t really be driven and directed like some Hollywood movie. Going with the natural ebb and flow of nature is the best scenario, but is often a difficult exercise.

After a full day of crying and making calls to various counselors in the Phoenix area, I was told I could not receive financial assistance for any emotional or physical support or treatment until I was a resident. That meant I would have to stay there eight more months before I could afford care. I called my sister. I did not expect her to be so honest and forthright about how she felt. For the first time, she let me know that while she loved me and supported me, she was convinced that getting over an eating disorder was going to have to come from within. She was right; after all, I had spent thousands of dollars on hospitals, alternative medicine, books and therapists with no tangible results. I was like a chronic drunk who attends many Alcoholics Anonymous meetings without actually working the steps, assuming that something outside her could be the cure. While many of these avenues had given me greater insight into the disorder, none helped me overcome the problem. I understood my illness on an intellectual level, but I couldn't put it together in a way that allowed me to heal from it. I needed to take a leap of faith and allow myself to trust myself and trust that letting go didn't have to be such a struggle. There was a part of me that knew a healthier way to live, even if I couldn’t visualize it perfectly. I had just never nurtured that part of me, because I was too caught up in punishing myself. I believed fully in Geneen Roth’s method of living – listening to your body’s inner wisdom and trusting that deep down, you know what your body needs. I knew in my heart everyone could learn to feel what hunger was and know when fullness occurred. What I didn’t realize at the time, though, was the physiology behind eating and fullness and how much that changes with prolonged food issues.

In normal people, when blood sugar drops, the liver sends signals to the hypothalamus alerting the brain that the body needs glucose, the sugar the body breaks down from food. At this point, physical hunger is often experienced when the stomach contracts and the urge to find food and eat is experienced. The hypothalamus also identifies particular foods your body needs and is thought to be responsible for cravings. After food has been consumed, hormones are released and again find their way to the hypothalamus as the food begins to move from the stomach into the intestines. These hormones tell the body it’s time to stop eating. One hormone, called leptin, is released from the fat cells themselves. Satiety occurs after all these hormones have traveled to the hypothalamus. Unfortunately, with both starvation and purging, it’s as if these hormones become downright confused and are hesitant to be released. It takes a much longer time for leptin to be released in a bulimic than in a normal person. This can often trigger another binge because the bulimic actually still feels hungry, despite having just eaten a normal meal. Since anorexics constantly override these hunger signals, hormonal chaos results and delayed hormone release is likely. It takes many weeks of regular meals to establish the hormonal connection that allows one to begin to read and recognize both hunger and fullness. It has been reported that some of the concentration-camp victims in World War II experienced a warped sense of body image. It is also known that some who survived starvation and the harsh conditions of the camps ate so much upon their release their stomachs burst. Clearly, the body this far out of balance is not able to regulate its own needs for survival.

After much consideration, I decided to move back to Boulder where I could at least find support from family and friends. In the meantime, I was determined to allow my body to rule my appetite. I figured I had already hit rock bottom, so anything, even gaining weight, could not be as bad as living the way I had been living. To celebrate my faith that I would survive and live to see a better life, I went out for ice cream, something I had not done in over 10 years. I had sometimes eaten frozen yogurt at home, but to actually go out and allow someone else to serve me was something I had not experienced since my days in college.

I remembered from my stay in the hospital that once my metabolism started working again, I would be hungry. I didn’t realize I would experience an almost frantic need for food. I would eventually have to address both the emotional deprivation and the extreme physical deprivation the years and years of anorexia had caused. At times I would become panicky at the thought of having to wait to eat. I was consuming food every few hours. When I packed my belongings and headed home, I was on a mission to eat exactly what I craved. On my drive to Colorado, I stopped at five different stores in search of a bran muffin. It took an extra hour to find one, but after such severe restriction, I was allowing myself some indulgences. My fear of gaining weight was definitely still right in my face, but it was as if my body had taken over. I didn’t fight my intense cravings, only the thoughts in my head that insisted I was already getting fat.

Unfortunately, after too many sugary meals and far too little protein, I set myself up for another short bout of bulimia. It seemed that no matter how much I ate, it wasn’t enough. Also, for some reason, I couldn’t exercise without crying. It was as if all my fears were coming back to haunt me. I buckled under the past trauma of performing and overtraining, starving and living compulsively. My self-esteem was shot to hell and I was desperate for reassurance that I was going to be okay. I followed my mom around like a little puppy dog in order to feel safe. I felt vulnerable and shy and was having a terrible time trying to regulate my food intake. It seemed that the pendulum had swung in the complete opposite direction and stayed there after being held so tightly on one side. I finally saw a psychiatrist who put me on an antipsychotic drug called clozapine and some antidepressants, including a low dose of Prozac. Eventually I started to reach some balance. I felt obese at just around 95 pounds, only 15 pounds heavier than my low point. This was still very thin, but my weight was creeping ever higher and my fear was that it wouldn’t stop increasing. My psychiatrist told me that one of two things would happen: Either I’d continue to be anorexic or I’d get healthy and end up hating my body. This was a Sophie's choice, and I didn’t believe him. I also couldn’t believe he would say something like that. I knew there were women out there who were healthy and tolerated their bodies. I had even heard of people who actually loved their bodies. I refused to accept those as my only two choices. I quit seeing him and attempted to take responsibility for my own wellness.

Since I was still struggling with a horrible self-image, despite my belief that others could overcome this issue, I decided that in addition to starting to run again, I was going to stop weighing myself. I could not deal with the numbers any longer. They made me crazy no matter what objective story they told, and I obsessed about being a certain weight when the scale was involved. It's terrible to consider how a number could determine how I felt about myself. I knew this then, yet I still couldn’t stand the thought of my weight going above that 100-pound mark. I tried hard to stick to some sort of regular eating pattern: breakfast, lunch, dinner, and one snack. It wasn’t long before I couldn’t stand the sight of myself, though, and I started restricting again.

The next few months were a roller coaster of eating what I felt was too much and then reverting back to sharply restricting calories. I was running again and back to working out several hours a day, mixing the running with biking, walking and calisthenics. It wasn’t long before I was struck down with another stress fracture in my pubic bone. A later diagnosis would show that, over the years, I had suffered several small fractures in addition to the larger one in that area. I took to biking and lifting. I was very shocked at how weak I was. I had no core strength despite all the running and compulsive aerobic exercise, which only burned what little muscle tissue I'd retained. My muscles did not seem to respond to weight training by getting bigger or stronger. Instead, they broke down. It was as if my body no longer knew how to synthesize muscle. I experienced chronic soreness in addition to a general feeling of not moving forward and feeling stuck, yet I continued to work out like a hamster trapped on a wheel.  

A therapist friend of mine and I decided that since I had a tendency toward bipolar disorder, I should stop the antidepressants. She suggested lithium, but I was too afraid of the possible weight gain. I already felt such self-loathing at just over 100 pounds. I couldn’t imagine gaining more weight and living with myself. I had stopped purging, but was still having difficulty finding balance. On a whim, I tried a product called SAM-e. I didn’t notice any great change at first, so I stopped taking it, but a month or so later I realized it had actually been easing the depression I had felt throughout my life.

As for my eating, a combination of what I thought was sensible and what my body was craving seemed the best approach, so I used a variation of the Zone Diet to achieve at least some sort of regularity in my life. I found that eating smaller meals throughout the day kept me from feeling panicky or overly worried. The smaller, more frequent meals kept me from getting overly hungry or weak and also helped keep metabolism going. The smaller meals were also much easier to digest and didn’t leave me feeling as bloated or full. To help keep my blood-sugar levels from fluctuating too much, I made sure not to eliminate entire food groups from my diet. Basically, instead of following any diet in particular, I learned to balance what I was craving with a sensible meal plan. I aimed for a bit of protein, carbohydrate and fat at each meal. Still, I relied heavily on calorie-counting strictly out of fear of gaining too much weight, and letting go completely seemed out of the question.

A few months later, when my stress fracture had healed, I began running again, and I decided I wanted to run a marathon. I knew it was risky, but I wanted to prove to myself that I had the ability to give my body what it needed to run that far. I wanted to prove to myself I could adapt. I needed to show the people around me I had courage, so I started training by running longer runs on the weekends. I knew that on some level I was a bit over the edge but considering where I had been, I was indeed healthier, at least emotionally.

During the time I trained for the marathon I met some amazing new people, people who showed me the meaning of true friends. Unaware I was continually complaining about how fat I felt, I was confronted by my running partners. They said that while they loved me, they didn’t want to hear me say “I feel fat” anymore. This led to a change in my conversational habits that ultimately helped ease the actual feeling. The more I moved away from saying that I felt fat, the more I moved away from actually feeling fat. Eventually, I even thought about it less. The noise of these obsessive thoughts was decreasing over time. When I began to have panic attacks, another friend, Misty, suggested I wasn’t eating enough. She pointed out the pattern of my panic attacks and suggested I try eating a bit more each day. She said, “Look, you know that what you’re doing isn’t working, so just change.” I laughed, “What?” I couldn’t “just change.” Or could I? I had never thought about it, but she was right. “Just try something different for a week, and if it doesn’t work, you can always go back to what you were doing before,” Misty said. “Chances are, though, you won’t want to. If all else fails, try something completely different” And all of a sudden, I saw not one way out, but many. Infinite options were before me.

Change is hard for most people. It’s even more of a challenge for anorexics. They tend to set rules in concrete and develop rituals that may appear meaningless to others but are as essential as a life-sustaining breath of air to them. In addition, they are some of the best game-players in the world. No matter the extent to which rules around food, deprivation, and exercise threaten their lives, they will do what it takes to stay the course. It’s easy for an outsider to suggest that they just eat something, simply change the rules, but this is nearly impossible for someone trapped in the grip of such an illness. The desire to be well may be there, but the means to becoming well is missing. The thought of simply eating something outside the rules set is just not an option. There is no going cold turkey with anorexia. Unlike stopping other addictions, it’s impossible to have an all-or-nothing avenue for recovery. Instead, it’s more a matter of gradual change, baby steps. Although the analogy of a smoker having to smoke only half a cigarette is not quite accurate because cigarettes are not ultimately healthy for the body, in terms of addiction, the difficulty of this scenario would compare to what an anorexic has to do in order to recover.

When it comes to eating disorders, it often takes someone outside to allow for the permission of a change in the rule book. At times when exhaustion from dealing with the disorder and all that it brings sets in, an anorexic will welcome outside help and agree that someone other than herself needs to step in and take control. It takes an enormous amount of strength for this change to come from within. Whether the initial change happens as the result of allowing someone else to take control or from allowing the body’s needs to finally be heard, it is the only thing that will ultimately lead to recovery. Finding self-worth and discovering self-love are integral parts of reclaiming health. Simply gaining weight is not the cure to anorexia, and it's essential to feel worthy in order to heal. Listening to the inner self – the self that longs to live and be free and play by rules that are not so strict – is the real cure.

Anorexics have a tendency to see the world in black and white. It’s either-or; there’s no living in the grey. It occurred to me in the middle of my conversation with Misty that eating didn’t have to be a matter of starving or being fat; it could possibly be something in between. With this broad new view of my once-limited world, I was able to occasionally add snacks to my daily diet as needed. The panic attacks were fairly manageable and seemed to lessen with proper nutrition and by avoiding caffeine. The panic attacks would eventually get worse, but at the time they were not overly worrisome. I finished the marathon almost completely anonymously in an unimpressive time of 3:49 that included two stops – one to talk to a friend on the sidelines and one to use the portable toilet – but I found that I had accomplished a great feat. I had discovered my ability to listen to my body.

I would find out later that listening to my body could be disrupted and would become nearly impossible with so much damage already done to it. For some unknown reason, my body was continuing to break down despite an improved diet and a strict “no purging” policy; it was as if I had passed some physical point of no return, like a former smoker who quits too late to keep her emphysema from gradually worsening in spite of having given up cigarettes. And so it was that just when I thought I was getting on my feet, I faced the fact that despite not yet being 35 years old, I might have already caused irreversible damage to my body.

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Thursday, July 28, 2016

Training on Empty: Chapter 28 (Possible TW)

Possible trigger warning with mention of behaviors.

Chapter 28 – The Long Road

“Courage consists of the power of self-recovery.” – Julie Arabi

Anyone who has suffered an eating disorder can tell you how increasingly distorted life becomes the longer the illness progresses. It’s hard to imagine being so lost and so stuck that hope disappears. There was a point in my illness where I had crossed over to what I truly believed was a point of no return.

When I was younger, I was at least somewhat well-rounded. I painted and drew, cooked, read books and watched movies. I don’t recall doing much of anything once my weight became so abnormally low. I also don’t recall exactly when it was that I stopped being in the world. I was isolated, except for a few select friends who could tolerate the sight of me, and I had dropped all hobbies and interests from my life. Days on end were spent exercising, though it’s hard to imagine exercising with no real strength. I also spent my time waiting for my two small meals: one in the evening, one late at night. Occasionally, there were days I would eat more normally and even some days on which I would binge, but the guilt was extreme and often very hard to handle. At the time I couldn’t see that those days of eating normally were what my body, mind and spirit craved.
Winters had always been hard on me, but when I weighed so little they became downright dreadful. I shivered in the top-of-the-line winter gear my mom had bought, freezing while others around me enjoyed the brisk air. Rather than risk another winter of extreme cold, I decided to seek warmer climates. Just a few months after being released from the hospital, I found a job at a Montessori school in Phoenix and left Boulder, hoping the new environment would not only ease the trauma of surviving harsh winters, but also allow me to escape my past. Yes, I was running away from my problems or at least attempting to escape. I wanted to get well, pay my parents back for all the money they spent on me and participate in the world again, but I couldn’t face the possible comments from other people about any weight gain. My thinness was what defined me, and I knew from past experience how hard it would be to change. Understandably, well-meaning people who would say, “You look healthy” or “you’ve gained weight” did not know that for me, those words translated to “you’re fat.” Those were the words I knew would devastate me. I was hoping that if nobody knew me as an anorexic, I might be able to change. Instead, the new environment and added stress of living on my own caused me to revert back to my most compulsive regime in terms of both exercise and eating.

Instead of getting better, I got worse. My weight was just below 80 pounds at times, and I was constantly sick. Though the seizures had stopped, my immune system could not fight off colds, the flu, or any illness floating in the warm desert air. I missed many days of work at a time. During times of illness, my fevers would spike so high I worried for my life. I would shiver and sweat the nights away and wait for morning to come, hoping I would wake to see one more day yet tired of facing these days.

When I wasn’t sick and merely trying to survive, I was compulsive, dragging myself through the days. I often called my sister or my friend, Heidi, in tears. I had no idea how selfish I was being at the time; all I could see was my own pain. I was miserable, living a marginal life. It took years before I could see the strain I put on others and how very much my friends and family suffered with my disorder. I had no idea of the sadness and anger my sister felt over losing her little sister who was, in fact, alive but not living. She felt cheated, not having a relative she could do things with, and admitted that she was tired of having to walk on eggshells around me, afraid that anything she said could upset me and potentially worsen or trigger my bad eating habits. She missed having someone she could do things with and talk to about things other than food and body image. It had been years since I had gone clothes shopping or gone out to eat with anyone. These were things my sister did with friends, because I wasn’t able to be a part of her life with my distorted thinking.

People at work were concerned about me and often tried to encourage me to eat. I refused. I was good with the kids and I loved what I was doing, but at times I felt terribly weak. I was unable to lift or carry most of the children, and I remember disappointing one heavier boy when I couldn’t lift him up onto the playground jungle gym. My heart went out to him, knowing exactly how he must have felt, but I was in no condition to be lifting the youngsters.

The kids where I worked were exceptional. They seemed wise beyond their years and had no problem making me feel welcome and wanted. To them it didn’t matter what my weight was; they just wanted someone to listen to them, play with them and teach them. While basically getting paid to play with these kids, it occurred to me that I had really missed out as a child. Although I had played with the other kids in the neighborhood, I always felt like an outcast, not accepted. It was the first time other children wanted me to be a part of the group, even though I was an adult. I longed to have their innate wisdom regarding wants and needs and their sense of joy about life. Mostly, I longed to have their carefree attitude toward food.

One day, not long after settling into a regular routine of workouts and work, I noticed that one of my teeth was hurting. I made an appointment with a local dentist and he discovered a sinus infection. He also discovered that I had an infection on both sides of my upper jaw. Apparently, after all four of my wisdom teeth were removed many years earlier, an infection eventually developed in two of the empty tooth sockets. The dentist had to go back into the socket to clean out the infection. I was scheduled for surgery just a few days later. The surgery was long and draining. I was supposed to return to work the following week, but my face was so bruised and swollen on my already too-tiny body that the director of the school where I worked was afraid I would scare the children. I sat home for a few more days until the swelling subsided and returned only to have the kids comment on my terribly pale, slightly yellow complexion. It was becoming all too obvious that my anorexia was affecting my liver and I was jaundiced.

Not long after the surgery, I developed another injury. My diet continued to be incredibly unbalanced and I was still compulsively exercising, running on a sore leg and doing calisthenics. Eventually the pain got to be too much, so rather than fight it, I stopped running. In order to reduce the fear of gaining weight, I decided to try a few days of a modified juice fast. My daily intake consisted of vegetable juice plus a little brown rice and vegetables. No other solid foods were allowed. After a few days I was starving. I binged and purged and called in sick to work. I was a complete mess emotionally and physically. When I went into the bathroom to wash away the tears, I stared darkly at myself in the mirror, my self-hatred growing. My eyes penetrated the image in the mirror, looking deeply and critically at my reflection.

That’s when it happened.

I had an epiphany. For the first time ever, and the last time since, I saw myself exactly as I was. I saw the bones on my face, my ribs sticking out, my thinning hair, my sharp hip bones protruding and my bony knees sticking out over my tiny calves. I could even see the bones between my almost nonexistent breasts where my ribs met. My arms were frail and so, so small. I was shocked, horrified. I was amazed I was still alive and finally understood all the stares and odd looks I received. I had no idea how things had gotten this bad, and I certainly had no idea how things could possibly get better. I knew I was stuck. I also knew I needed help.

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Training on Empty: Chapter 27

PART III – White

Chapter 27 – Britta Kallevang

A poem by Britta Kallevang

I’ve never met a woman who could appear to be so grounded and confident, yet struggle with the very things that sent me over the edge. Because Britta was a runner, she was all too familiar with compulsive training and both food and body-image issues. Sometimes going through similar experiences can bond people together. I found a friend in Britta, and we both know that even when long expanses of time pass where we are not able to be in touch, we will always be there for one another. Britta has expressed some thoughts on her struggles in a completely different way: through poetry.

gut –
the head spins

the rest
is poles
thick and thin
a horizontal
up and down

tests its
at taking

and refers to
it out
spin spin

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Training on Empty: Chapter 26 (Possible TW)

Possible trigger warning with mention of behaviors and numbers.

Chapter 26 – Fear

“What is life? It is the flash of a firefly in the night. It is the breath of a buffalo in the wintertime. It is the little shadow which runs across the grass and loses itself in the sunset.” – Crowfoot, Blackfoot warrior and orator

Sometimes a person can get so caught up in a certain identity that he forgets who he really is. There are others who are more spiritually evolved who have an innate knowledge that who they are is not based on how much they make or what car they drive or even how fast they run. Self-acceptance is not often taught in this country. Celebrating yourself just because you exist is something I wish I had learned. Instead, it’s something I’m still trying to grasp.

By the time I reached 80 pounds, I had become so good at deception that I was even fooling myself. I was still honest as far as admitting I had eating issues, but I was so lost in the disease I could no longer decipher what was good for me and what was not. I was giving myself enemas daily, pretending it was helping rid my body of “toxins,” something I was told by a “healer.” Looking back, I realize that these enemas simply made me feel thinner, nothing more. That was the reason I continued to do them, not for any possible health benefit. My new identity was entirely wrapped up in my illness, and there was an incredible amount of fear around all of my actions. I was outright terrified of gaining weight at that point. I convinced myself and tried to convince others that the diabetes and other symptoms of anorexia were actually what caused the anorexia to become so severe, when in reality it was the other way around. The anorexia was causing all the other issues. It’s an odd thing; on some level I knew I wasn’t fooling anyone, yet on another level I actually believed my twisted explanations. I had lost sight of how thin I actually was. On the other hand, I was fully aware I was sick. People on the streets stopped and stared, mouths fell open when I walked by and looks of concern and fear surrounded me. Occasionally, someone would actually say something about how thin I was, but it was rare, not like when I was heavy as a child when everyone insisted on offering an opinion. Somehow being ridiculed for being fat is much more acceptable than being singled out for being thin, even though they are just different manifestations of the same core issues.

Like many anorexics, I developed little checks to reassure myself I was okay, i.e. thin enough for the day. My basic check was to wrap my hand around my upper arm to make sure my middle finger would touch my thumb. At one point, my check was to feel my hip bones, something I did continually throughout the day, even though I knew it was impossible to gain enough weight to change that drastically in a few hours. These were rituals that, over time, became habit. There were also lies and rationalizations that constantly fell from my lips. They weren’t outright intentional lies; “I ate earlier” didn’t seem like lying. I just didn’t tell anyone how much earlier it was when I last ate, and a “huge lunch” is all relative. My dedication to being honest was unintentionally waning and the line between reality and fantasy became more blurred in my head.

Looking back, I can see how I fooled myself in order to hang on to my eating disorder. I wanted to justify what I was doing, so that I didn't come off as sick to others. I rationalized and tried to explain away my quirky behaviors, hoping those around me wouldn't think I was anorexic. I don't think I was very convincing, but I continued trying to hide my disorder. Being on the other side of the illness, I now understand how frustrating it is to hear someone try to explain her strange behavior that doesn't support health with bizarre and irrational excuses.

When I see anorexic people today, I can detect rather quickly how far into the disease they are without taking great notice of their actual body weight. It’s one of those “anorexics can’t fool other anorexics” phenomena that occur once anorexia has been experienced on any level. It’s obvious when the anorexic is visibly thin, but there are other indicators. Aside from the little checks they do, I can see the illness in the eyes. Anorexics have a certain look. If it’s severe, the look is vacant. If the person is recovering, the look is pained and deep.

By the time I had my first seizure, I was completely lost. I had recently given most of my possessions away, thinking the end was near. I could feel myself slipping further and further away from the world around me. Consumed by obsessive-compulsive behavior, it was a struggle to make it through the day. It seemed that the thinner I got, the worse the OCD symptoms became. It got so that picking out an apple at the grocery store was an impossible task. I felt like Persephone seeking out prettier and prettier flowers in the fields. Each time I would settle on an apple I thought might be okay, I’d think maybe there was a better one. Only very rarely could I actually choose one that was acceptable. Finding the right one actually had little to do with size, shape or ripeness, it just had to “feel” right.

I’m sad to say that even after my first seizure, I wasn’t ready to make an effort to get well. It would have been difficult even if I had been ready, because my finances were pretty well exhausted. Any treatment facility was out of the question. Besides, I felt I was losing the fight. Being healthy takes balls. Claiming the right to life and having radical trust in the universe is not for the weak. Embracing self-worth and self-wisdom takes an enormous amount of sheer strength and faith. I don’t mean that in the typical religious sense, but faith nonetheless. Simply put, being human takes energy.

Because I had become so sick, I no longer felt like a woman. Even in high school, when I was so thin, I had a sense of my femininity. However, once I become so terribly emaciated, I felt asexual and made little effort to dress or care for myself except for basic hygiene. It was more important to me to remain thin than to evolve as a person, even though on some level I wanted to be well. The worst part during all of this was that I could feel my mind losing ground. Up until that point in my life, my mind had always been razor-sharp and overactive. Thoughts flooded my brain and creativity oozed from my very being. All of a sudden, I was living in a haze and experiencing things in slow motion. Then, horror of all horrors, I felt my thoughts escape the bounds of my own control.

As hard as I tried to focus my mind by reading or concentrating, I just couldn’t. What I didn't know is that my serum sodium level was dangerously low; I had diluted my electrolytes through excessive water intake, and this condition – called hyponatremia – was causing my brain to short-circuit. Complete and utter panic grabbed me to my very soul and I knew something terrible was happening. Instead of calmness and nice white lights near-death survivors often claim to experience, I came face to face with paralysis, blackness and complete loss of control. After the seizures would pass, I would remember bits and pieces of the events leading up to the seizure itself; the tingle in my back, the repetitive thought that was stuck on replay, and the screaming that came from my mouth but seemed so far away.

Each visit to the hospital was expensive. The ambulance ride alone was close to $1,000 per trip. My insurance company had dropped me after my second hospital stay, so my parents footed the bill. After I was told the seizures were not exactly life-threatening, I wore a small necklace with a sign attached to it that read, “in case of seizure, please do not call an ambulance.” After two trips, my parents couldn’t afford to pay for another ride for me.

When I woke up one night to severe chest pain and shortness of breath, I thought for sure that was it. My mom and I took a cab to the hospital, where the doctors told her not to expect me to make it through the night. I begged them to find room for me at an eating-disorders treatment facility. Their response was, “Sorry, they’re full.” I looked at my mom and asked, “How sick do I have to be?”  Clearly I was going to have to figure this out on my own. The real question was: Did I even want to get well?

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